‘The whole point of this book’, the award-winning epidemiologist Professor Tim Spector informs readers of Spoon-Fed, ‘is not to tell you how or what to eat’ – a refreshing change for those who have to put up with me boring on about the evils of refined sugars and the glories of gut flora, depending on which paperback I’m clutching at that moment. While most books in the genre of popular nutritional science tend to leave one with a firm, if sometimes short-lived, sense of conviction in the diet department, I closed this one feeling discombobulated, stripped of many of the old certainties but without much to confidently put in their place.
This is not to say that Spoon-Fed isn’t worth reading: better to know nothing than to put your faith in falsehoods. I spend every winter gorging on citrus fruit in the belief that, if it won’t protect me against a global pandemic, it might at least ward off a few colds. Although fruit is useful in other ways, Spector informs me that the idea that vitamin C might boost my immune system is based on a single sixty-year-old hypothesis with no evidence to back it up. The best that can be said is that ‘a few studies have shown that if taken with zinc supplements, vitamin C might reduce cold symptoms by an average of about six to twelve hours’.
Such sacred cows fall thick and fast in this slim but densely packed volume. Skipping breakfast might actually be good for some of us, consuming three to four cups of coffee a day is associated with a significantly reduced risk of heart disease, cutting back on salt is unlikely to make a difference to most people’s health and there’s ‘a complete lack of evidence’ that there’s any particular benefit in eating fish (though increased consumption does have a clear environmental downside). ‘Within the past decade,’ Spector writes, ‘I have changed my mind on most of the subjects in this book, including diet drinks, veganism, eating fish, caffeine, vitamin supplements, pregnancy advice, organic foods and the effects of the environment.’ The poor old reader has to digest all this new information in one go; fortunately, Spector’s not against the odd glass of wine to soften the blow.
Spector is great at explaining just why so much of what we believe about food and nutrition is at best debatable and at worst downright wrong, but he’s not able to offer much prospect of change. There’s a serious lack of cash for truly objective studies on the subject for a start; in the USA, the food industry provides 70 per cent of the funding for research into nutrition, and the picture is much the same elsewhere, a situation that Spector likens to the tobacco industry’s efforts to ‘distract us from the real science in the 1960s and 1970s. These successful tactics meant the first proper clinical trial of the harms of junk food versus unprocessed food was only performed in 2019.’
NHS doctors are given little in the way of nutritional training (Spector reckons that no ‘serious scientist’ now believes that cholesterol in food is to blame for heart disease: tell that to my mother’s GP), and we in the media are often guilty of oversimplifying developments in nutritional science. All those ‘bacon causes cancer’ headlines following the publication of a World Health Organization report into red and processed meats in 2015 failed, according to Spector, to put the findings into context: to have the same risk of developing cancer as a daily smoker, he claims, you’d need to be consuming a hundred rashers a day.
Even calorie counts, which I believed to be the most basic and indisputable of food-related facts, are shown to be hardly more than estimates, as well as largely irrelevant when it comes to their effects on individual consumers. Not only is it hard to carry out long-term nutritional studies on human subjects with any degree of accuracy, but our responses are so different that Spector is able to call the ‘assumption we are all identical machines’ the ‘most prevalent and dangerous myth about food’.
This is, however, where Spector is able to offer a glimmer of hope for the future, in the form of a project he’s working on with a commercial nutrition company to develop personalised products for the consumer market. Although I appreciate and share his excitement, by the fourth or fifth mention it does begin to feel like little more than a plug. The other minor quibble I have with this otherwise impressively digestible book is the unquestioning use of terms like ‘artisan’ and ‘quality’ to mean healthy. Spector understands the importance of making good food options more attractive and accessible to those with limited resources, yet sentences like ‘I think heavy and binge drinking should be targeted, not those relaxing over a leisurely meal with a fine glass of wine’ risk coming across as both blinkered and entitled.
Yet though Spoon-Fed unapologetically raises far more questions than it answers, this survey of the ‘known unknowns’ of nutrition reads like a clarion call for change, as well as for better standards in science and its dissemination. If diet is indeed ‘the most important medicine we all possess’, this book should be available on prescription.